Benzodiazepine abuse, misuse, dependence, and withdrawal among schizophrenic patients: A review of the literature

Iglesia-Larrad, Javier I. de la; Barral, Carmen; Casado‐Espada, Nerea M.; Alarcón, Rubén de; Maciá-Casas, Ana; Vicente-Hernández, Begoña; Roncero, Carlos

doi:10.1016/j.psychres.2019.112660

Cited by 19 publications

(9 citation statements)

References 51 publications

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“…Benzodiazepines are the most widely sold group of drugs for sleep disorders, as has already been described in other series of addict patients [ 2 ] and mental health patients [ 63 ]. Benzodiazepine use disorder is common in patients who are being treated for a different addiction.…”

Section: Discussionmentioning

confidence: 99%

The Relevance of Dual Diagnoses among Drug-Dependent Patients with Sleep Disorders

Roncero

García-Ullán

Bullón

et al. 2020

JCM

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Background: Sleep disorders are often associated with drug use. Nearly 70% of patients admitted for detoxification report sleep problems. Dual disorder (DD) is the comorbidity between mental disorders in general and disorders related to psychoactive substance use. The association between substance use and sleep disorders (SD) appears to be bidirectional. Our objective is to analyze the association between sleep disturbance history and drug use pattern (alcohol, cannabis, opioids, and cocaine). Methods: Analysis of data in the first interview at the Addictions Unit of the Department of Psychiatry at the University of Salamanca Health Care Complex between October 2017 and January 2020. The sample consists of 398 patients. We studied the association between different variables: origin of patients (Inpatient Dual Diagnosis Detoxification Unit (IDDDU) vs. Outpatient Drug Clinic (ODC), presence of affective disorder, psychotic disorder, type of drug used, and treatment. Results: Of patients with DD, 62% had more delayed sleep induction, sleep fragmentation, early awakening, and nightmares. Outpatients had more difficulty falling asleep because, in many cases, they had not previously sought any medical assistance. On the other hand, 67% of the patients with insomnia presented depression. Conclusions: There is evidence of a harmful association between DD and SD.

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Section: Discussionmentioning

confidence: 99%

The Relevance of Dual Diagnoses among Drug-Dependent Patients with Sleep Disorders

Roncero

García-Ullán

Bullón

et al. 2020

JCM

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“…Nearly half the included patients received concomitant treatment with psychotropic drugs, most frequently antidepressants, followed by anxiolytics. Although CPGs recommend benzodiazepines for anxiety and insomnia, especially in the acute phase of schizophrenia 43 , the overwhelming majority of the people receiving a hypnotic treatment did not have a diagnosis of sleep disorder, and a third of those who were prescribed an anxiolytic drug did not have a diagnosis of anxiety. As for depression, a common disorder in schizophrenia 44 , 70% of those treated with antidepressants did not have an associated diagnosis of depression.…”

Section: Discussionmentioning

confidence: 99%

Treatment patterns and appropriateness of antipsychotic prescriptions in patients with schizophrenia

Gamón

Hurtado

Salazar-Fraile

et al. 2021

Sci Rep

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Schizophrenia is a chronic mental condition presenting a wide range of symptoms. Although it has a low prevalence compared to other mental conditions, it has a negative impact on social and occupational functions. This study aimed to assess the appropriateness of antipsychotic medications administered to schizophrenic patients and describe current treatment patterns for schizophrenia. A retrospective cohort study was conducted in all patients over the age of 15 with an active diagnosis of schizophrenia and treated with antipsychotics between 2008 and 2013 in the Valencia region. A total of 19,718 patients were eligible for inclusion. The main outcome assessed was inappropriateness of the pharmacotherapeutic management, including polypharmacy use. Altogether, 30.4% of patients received antipsychotic polypharmacy, and 6.8% were prescribed three or more antipsychotics. Overdosage affected 318 individuals (1.6%), and 21.5% used concomitant psychotropics without an associated psychiatric diagnosis. Women and people with a comorbid condition like anxiety or depression were less likely to receive antipsychotic polypharmacy. In contrast, increased polypharmacy was associated with concomitant treatment with other psychoactive drugs, and only in user on maintenance therapy, with more visits to the mental health hospital. Overall, we observed a high level of inappropriateness in antipsychotic prescriptions. Greater adherence to guidelines could maximize the benefits of antipsychotic medications while minimizing risk of adverse effects.

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“…Antidepressants were the most commonly prescribed psychotropic drugs, followed by anxiolytics. Although benzodiazepines are recommended by CPGs for the treatment of anxiety and insomnia, especially in the acute phase of schizophrenia [40], an overwhelming majority of subjects receiving a hypnotic treatment did not have a diagnosis of sleep disorder and a third of those who were prescribed an anxiolytic drug did not have a diagnosis of anxiety. As for depression, a common disorder in schizophrenia [41], 70% of subjects treated with antidepressants did not have an associated diagnosis of depression.…”

Section: Discussionmentioning

confidence: 99%

Treatment Patterns and Appropriateness of Antipsychotic Prescriptions in Patients with Schizophrenia

Gamón

Hurtado

Salazar-Fraile

et al. 2021

Preprint

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Schizophrenia is a chronic mental condition presenting a wide range of symptoms. Although this mental disorder has a low prevalence in comparison to other mental conditions, it has a negative impact on social and occupational functioning. This study is aimed to assess the inappropriateness of antipsychotic medication among schizophrenic patients and describe current patterns in the treatment of schizophrenia. A retrospective cohort study was conducted including all patients over the age of 15 with an active diagnosis of schizophrenia and treated with antipsychotics between 2008 and 2013 in the Valencia region. 19,718 patients with a diagnosis of schizophrenia and treated with antipsychotic medication were identified. The main outcome was inappropriateness of the pharmacotherapeutic management, including polypharmacy use: 30.4% of patients received antipsychotic polypharmacy (6.8% were prescribed 3 or more antipsychotics); overdosage: a total of 318 individuals (1.6%) exceeded the maximum daily doses; and use of concomitant psychotropics without an associated diagnosis: 21.5% of patients received psychotropic drugs concomitantly without associated psychiatric diagnoses. Overall, females and those who had a comorbid condition, such as anxiety or depression, were less likely to receive antipsychotic polypharmacy. In contrast, concomitant treatment with other psychoactive drugs, such as antiparkinson drugs, anxiolytics and hypnotics and more visits to mental health hospital increased the risk of polypharmacy use. In conclusion, a high level of inappropriateness has been detected among antipsychotic prescriptions. Practitioners should follow guidelines recommendations whenever possible in order to obtain the maximum benefit of antipsychotic medications without an increased risk of adverse effects in patients.

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Benzodiazepine abuse, misuse, dependence, and withdrawal among schizophrenic patients: A review of the literature

Cited by 19 publications

References 51 publications

The Relevance of Dual Diagnoses among Drug-Dependent Patients with Sleep Disorders

The Relevance of Dual Diagnoses among Drug-Dependent Patients with Sleep Disorders

Treatment patterns and appropriateness of antipsychotic prescriptions in patients with schizophrenia

Treatment Patterns and Appropriateness of Antipsychotic Prescriptions in Patients with Schizophrenia

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